State rejects proposals for fixing issues at de Groot nursing home

State public health officials, who filed a 94-page report citing numerous deficiencies at a San Luis Obispo nursing home for mentally or physically disabled children, have rejected two plans by the home’s operator to fix the problems.

In addition, state officials say, their most recent report based on a three-day survey of the home includes problems found in earlier visits that in some cases — including outdated physical and dental exams — have gotten worse.

Sjany de Groot, who has operated her facility on Buchon Street since 1980, has until Sept. 30 to submit a plan of correction that the state deems acceptable or face termination from the Medi-Cal program, from which she receives funding to care for the children living at her home.

In an interview Friday, de Groot, 86, said she has submitted two plans of correction, both of which were denied by the California Public Health Department’s health and human services agency.

She said she is convinced state regulators want to stop her from operating. Even if some changes are made, inspectors will come up with other problems and find a way to cut her funding, she said.

“Let them do it,” she said. “My home will stay open.”

The state Public Health Department provided a redacted copy of the report that contains a list of findings from a three-day visit by two state inspectors and one federal surveyor between June 30 and July 2.

There are five children at the home, ranging in age from 2 to 16 years old; the report’s “sample size” was three of the children (all names were redacted from the report).

Investigators found two issues they determined put the children in “immediate jeopardy” — (not) ensuring client safety and privacy while bathing, and a potential for infections from storing dirty linens and diapers in the same area where medication was prepared and where the children receive baths.

The report noted that a plan of correction was presented on those issues and accepted the same day so that the immediately jeopardy status was removed.

In its list of other deficiencies, the report said the facility doesn’t have enough staff to ensure each child has an active treatment plan with structured activities, which is “denying all five clients the right to achieve functioning at their highest level possible.”

For example, a child was able to grasp a spoon and return it for a refill of food, but the skill was not reinforced and the child was spoon-fed instead.

Another child was observed over three days either sitting up in a wheelchair in front of a television, or lying in a crib, without structured individual activities.

De Groot disputes the contention that the children don’t have structured schedules with activities.

On Friday, Gail Brochtrup, a special education teacher with the San Luis Coastal Unified School District, was conducting a special day class at the home.

Class is held three days a week during the school year. There is also a five-week summer program with a reduced number of classes.

Each child has goals based on their skill level and ability, including targets related to feeding and socialization skills, said Brochtrup, who said she documents their progress.

With one child, she sings songs and reads stories. Another is learning the alphabet.

“It’s funny that they have never been here when I’ve been here,” Brochtrup said. “I don’t know that they know the functional level of these children.”

Other issues investigators identified in the report include deflated wheelchair tires, outdated medical exams, no consulting services for physical therapy for one of the children since 2007, not enough paid staff working 24 hours a day, and a failure to ensure that each child had a closet and bedroom — the latter defined as a room with an outside wall.

De Groot said in a previous interview that she didn’t know how to alter her home to add walls to provide privacy between beds. She also suffers from claustrophobia and wants to be able to easily see all of the children, she said.

“I will not put my kids in jail,” she said.

The children sleep in a large, L-shaped room with partitions between some beds. A room divider can be pulled across to close off one area.

De Groot, a registered nurse, said she is required to have two paid staff members on at all times, which she does during the day shifts. In the evening, she works with one of her daughters, who is considered a volunteer. At night, she works with one paid nurse.

Regarding staffing, the state report states: “The facility must not depend upon clients or volunteers to perform direct care services for the facility.”

Corey Egel, a spokesman for the state Public Health Department, said the agency could not confirm staffing requirements because they are based on private patient information.

San Luis Obispo pediatrician Rene Bravo, a longtime physician for the home, also disputed some of the deficiencies, including the finding that the children aren’t receiving regular exams. Bravo said he conducts regular checkups every six weeks.

“Those kids get seen all the time,” Bravo said. “They are trying to fix something that isn’t broken for clients who receive better than anything, and it is grossly unfair.”

He said de Groot has copies of all exams and visits the children receive. He said physical therapy is usually provided by volunteers — which the report had noted was a violation.

Bravo said he was on vacation when investigators visited, and investigators didn’t try to reach him for comment.

In response, state health department spokesman Scott Sandow said in an email, “during the survey, observations, record reviews and interviews were collected that support the deficiencies cited. No further evidence is collected after the survey is completed.”

De Groot submitted two plans of correction, one on Aug. 6 and another on Aug. 19. On Aug. 11, she had a conference call with state inspectors.

They offered to meet with her at their Ventura office, but de Groot declined, preferring them to come to her “so they can see the kids.” They did not visit.

The state will not release the correction plan as a public record until it is approved, but de Groot showed an Aug. 22 letter from the department’s licensing office in Ventura explaining why her facility failed to meet federal requirements.

According to the letter, the plan did not indicate how corrections would be made, how the facility would prevent a reoccurrence, and said the correction plan did not relate to the cited deficiency.

Sandow said previous surveys of the home noted some of the same issues as highlighted in the most recent report, but “during the most recent survey these issues were identified at an increased severity.”

When asked whether there had been any changes in laws, regulations or personnel to prompt such a lengthy list of deficiencies, Sandow responded: “No, there have been no changes in laws/regulations, and the nursing home’s designation has not changed.”

In the meantime, de Groot continues to watch over the children, and wait, in anticipation of her funding being cut.

“If there are people who can help after,” she said, “we can really use it.”

She has seen an outpouring of community support since news of the state Public Health Department report was made public.

Supporters have offered help, raised money and signed an online petition to urge the state to keep the facility open. Assemblyman Katcho Achadjian has also been in touch with state public health officials and has offered to act as a liaison between the nursing home and the state if needed.

A large white sign was planted a few days ago in Sjany de Groot’s front yard, its large red letters pleading, “HELP SAVE THE DeGROOT HOME.”

The second line reads, “In danger of shutting down.”

When asked when she installed the sign, de Groot waved her hand and said, “I didn’t do it. The firemen did.”

This story was originally published August 29, 2014 at 6:57 PM with the headline "State rejects proposals for fixing issues at de Groot nursing home."